They are fighting against regulations requiring a certain amount of physician supervision:
The osteopathic group maintained at the hearing that patients do not get quality health care from a PA if the supervising physician does not initially see the patient and have on-site supervision.The opposition groups say the two-year PA training, master’s level degrees and prior medical work does not qualify them to see patients alone, without the doctor being in the building.
Related posts:
- Do physician assistants need work-hour restrictions too?
- Physician assistants and nurse practitioners are staffing rural ERs full time
- Why nurse practitioners and physician assistants will not solve the primary care shortage
- Should physician assistants be re-named?
- My take: EHR adoption, MDs with MBAs, allegations
- Even physician assistants are dissing primary care
- Can medical school expansion revitalize physician training?
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{ 4 comments }
I think it’s money-grubbing on the part of PAs, who want to maintain or increase hours on the job, and the doctors, who want to keep the office open and generating income when they aren’t around. This has nothing to do with patient access to care.
I’ve heard about PAs working by themselves under the license of a doctor. The doctor may be allowing several PAs to work under him/her and collecting revenue from all of them.
How can we require a doctor to be educated for minimum 7 years, a PA 2 years, and allow them to do the same job? Why do we require so much from doctors, or so little from PAs? I think that primary care providers learn the bulk of “how to do it” on the job. So a PA who has been working for a while probably has a really good grasp on everything primary care. So should they be able to practice without a doctor in the office? Are they the same as a doctor?
If I was a PA I’d want more autonomy so I could demand more money for increased responsibility, and then I could eventually push for laws allowing me to open my own primary care clinic without physician supervision.
As a doctor, I’d want to allow more PA autonomy to an extent. Just enough so I could keep PAs under me so that they couldn’t go out on their own, but enough autonomy so they could see all my patients and I could simply pull my income off their backs.
PAs and NPs are like fleas on the back of an elephant – pretty soon they feel bigger than the elephant!
-with attitude to boot!
they want to be treated and paid like doctors without having to go thru the same rigorous training [with enormous debt]doctors go through; they’d rather get master’s and phd’s to put these letter credentials after their names; how many Dr. PA, PhD. ’s have you encountered for real? I have seen a few…and many more tickled pink when a patient who dont care or looking for 2ndary gain, massage their egos by addressing them as doctors
PA’s are awesome for a basic run-of -the-mill case. The difference, however comes in the differential and a more in depth understanding of the pathophys of disease. Got sent a patient in the ED today from a PA at a clinic. Got called from a heme-onc telling me the pt was coming. Hgb from 12 to 6 in 4 months, pre syncopal and pale. PA called heme-onc and requested a direct admit to their service for anemia. Turns out pt with thick, stinky, tarry stools for several months. GI bleed ended up in the ICU for anemia and hypotension. PA thought it was a blood thing since pt unaware of blood per blttom. No rectal done. I work sisde by side with a BUNCH of great PA’s, but when sick or potentially sick patients roll through, they seem to be slow in recognizing it, and grasping the hidden reasons why. Goes back to training. Horses are horses and usually thats enough. A herd of zebras can still bowl your ass over if you don’t know where they are hiding. MD’s/DO’s just happen to have studied the map longer.
It’s like this movement by psychologists to get permission to prescribe drugs. They are below the “ignorance thereshold” –too ignorant to know what that they are ignorant. The programs that they claim qualify them to prescribe takes a social science major (not natural sciences like premeds) and gives them about the same number of hours of medical lecture that a medical student gets before he goes home for Thanksgiving break the freshman year. Then he gets contact with prescribing in a handful of patients–by the time I finished residency, I had seen about 4000 different patients.
So it is now not even a question of “how little” medical training is needed. Two states are taking people with NO medical training and lets them prescribe after weekend classes. The patients mostly don’t know. They think if it wears a white coat and has the “look” it is a doctor, and if it is called “doctor” then it is a physician.
We are in a pre-Flexnerian age when ignorance and low to no standards are becoming the new norm. Buyer beware and let the devil take the hindmost.
IMHO, PA’s and NP’s should be seeing patients with previously worked up chronic conditions with a well-worked out protocol to follow. It is exactly in primary care patients with seemingly minor complaints where the physician is needed to detect the casess of lifethreatening zebras.
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